Ok.
What do you do when you can’t eat? Let’s assume this is pretty predicable (like fasting for a test), or out somewhere that you know you won’t get to eat until a lot later?
Do you just skip the insulin and the eating until you know when you can eat again / controllably dose insulin?
You don’t take Insulin unless you’re going to eat. Your blood sugar would go way down and you would go hypo. Also you can’t go too long without eating or your blood sugar goes down and you can go hypo. You must monitor it closely and test often. I suggest you carry some emergency snacks with you if it’s possible that you just won’t be able to have a meal at the right time.
Yes, don’t take insulin if you’re not going to eat. You’ll crash without food if you take insulin.
I skip lunch frequently. With correct basal doses, no one should have lows when postponing or missing a meal.
More difficult with mixed insulin. What are you using–70/30?
Wow, mixed insulin. Invented just after stoneage and before the color tv. And yes, it forces you to eat.
You need to eat regularly on 70/30. Hope there’s an option for you to use another type of insulin because 70/30 is a nightmare. It’s unpredictable. The protamine in the NPH part of it can cause problems if you ever need surgery.
I always keep protein bars in my purse, so that if I’m out somewhere, and will miss lunch, then I can at lest get some food in me that way, and not go wacky with my BG. Always… and I will eat it, no matter where… at the store, the bus, wherever. Sometimes people look at me funny, but no one has said anything yet. lol
As far as a fasting test…you should ask your doctor what they would want you to do…Everybody is a little different. Depending on the tests my doctor has told me to keep taking my meds with water. I don’t like doing this because of the LOWS and meds tend to upset my stomach. You should try to schedule your fasting test around your sleep time. So most of the fasting time is actually sleeping and when you get up you are ready to give a sample.
You should always eat something. Skipping meals is not good unless you know how your body will react. With protein bars that are not necessarily for diabetics you need to watch the carbs and sugar content. Glucerna and Boost makes diabetic bars and drinks and they don’t taste bad. Some health nutrition companies are starting to target the diabetics. But always keep something around you. It doesn’t have to be a chuck roast but something lite for when you get the munchies…
hope this helps!
I do believe that’s one of those things that you have to do ---- EAT. If I have to fast for a test, I make sure that the test is scheduled for the earliest possible time I can get it, and if they can’t do it that early, then I tell them I am diabetic, and I can’t go too long without food. My latest time is 10:00 because that is about the same time I get done swimming, but then I eat something before I swim…so they have to do it before 10:00. Other times, I pack something in my purse or bag for those times, when you know you aren’t going to be eating “on schedule”…this is part of the game of controlling your sugars…and while everyone else is starving and wanting to eat, you have snacks to munch on…I see it as an upper.
Because I’m on a basal/bolus regimen the right dose of basal keeps me steady even if I don’t eat It sounds like maybe the 70/30 doesn’t do that? I of course don’t bolus if I’m not eating. For fasting blood tests I just take my basal, schedule the test for first thing in the morning (earlier than I like to get up!) then bolus and eat breakfast afterwards. The only time it was rough is when I had to do a medical procedure and wasn’t allowed to take my basal insulin either. The doctor was behind schedule it got later and later and I was starving and felt like crap. When I got home I was high but not crazy high.
Whoops, sorry, I didn’t see the other comments above for some reason, so I’m repeating some things others have said. Sounds to me, Sally, like you have a busy and not always predictable schedule and I definitely feel basal/bolus is the way to go.
Yeah, you can get basal and bolus human insulins. I’ve been on multiple daily injections where Novolog and Lantus, both human insulins, for years act as basal and bolus insulins. There are a number of others. Generally, basal insulins are long acting, like Lantus, and bolus insulins are short acting, like Novolog. Maybe you’ll go on an insulin pump right away that can be programmed to control true basal and bolus amounts of just a shorter acting insulin.
Lot’s of options!
Hello Gerri, what are the possible interactions of NPH and surgery? I am just curious because I have experienced extreme side effects from an anesthetic called scandicain (mepivacaine).
i’m not on insulin, at least not yet, but also very new (April 8, 2010) and on a steep learning curve myself. My first day on meds i went low and got nauseous on my way home from work. it was not a fun experience to say the least. I didn’t take my meds for 2 days after b/c i was having trouble getting a hold of my dr and letting him know what was goig on and get advice.
Monitor your sugar. You can’t check too often. it’s too bad they don’t have a real time all the time monitor.
it’s my understanding, and some may disagree, lows are more dangerous, in the short term, than highs. if oyu find yourself a little low, a small piece of candy to put you back on track shoudln’t hurt too bad, a jelly beans on 2, not a candy bar.
i hope this helps
Actually, the problem is with heparin, an anticoagulant given during a range of medical procedures. The use of NPH will leave you vulnerable to allergic reactions which can cause serious complications.
Protamine reacts with the reversal agent used to bring patients out of anesthesia.
Many women have had successful pregnancies on the analog insulins. You can use Humulin R for bolus, but it doesn’t work quickly to correct highs & sticks around about 5 hours in the body. Usually, people take R about 45 minutes before meals compared to rapid acting that’s injected about 15 minutes prior to eating. I use Regular because I have gastroparesis, but use Apidra to correct highs.
There are Type 1s who take metformin because they’re also insulin resistant. Better to find out the results of the C-peptide & GAD tests before taking meds you may not need.
Lantus & Levemir are your basal choices. Many discussions here about Levemir vs Lantus. I prefer Levemir hands down. I had afternoon lows with Lantus that made me nuts. I’ve found Levemir to be far more stable & even. Lantus is acidic & stings when injected. An opened vial of Levemir doesn’t expire for 6-8 weeks. Lantus starts to lose potency at day 26 & expires at day 28.
The anesthetic was only applied locally and by no means the dosage was meant to knock me out. But the anesthetic hit me very hard and to get out of anesthesia took more than 5 hours - even after the reversal agent has been applied. It was very scary because I was partly awake in some kind of vigil coma and my sense of hearing was my only connection to the outside world. Back then I was on NPH and I think I have experienced the problem you have described. I am kind of relieved now and will take my next anesthetic (may it never come) with more calmness and less fear. Thanks, Gerri!
What a terribly frightening experience! Hope you never have anesthesia again.
Well actually, that is not too bad a response. I rise 2-3 mg/dl per gram of carb, so a 30g meal will typically give me a 60-90 mg/dl rise (as a type 2). If my fasting is like 120 mg/dl, then a 30g meal will peak me (usually at 1hr) at 180-210 mg/dl. You actually did better. Should you be a type 1, maintaining whatever capability you have to still produce insulin is your #1 priority. Blood sugar levels over about 140 mg/dl (particularly sustained) are thought to damage your beta cells (through so called glucotoxicity). So I would encourage you to do your best to get a proper diagnosis and work to keep your blood sugar well controlled. And even if you turn out to be type 1 and make absolutely no insulin yourself, there is no reason you can’t treat yourself properly, control your blood sugar, get pregnant and have a perfectly normal pregnancy.